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NIOSH Publication No. 97-141:Musculoskeletal Disorders and Workplace Factors |
July 1997 |
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A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck,
Upper Extremity, and
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| Epidemiologic criteria used to examine studies of: | |
| 5a.1 | Carpal tunnel syndrome (CTS) associated with repetition/Risk indicator |
| 5a.2 | Carpal tunnel syndrome (CTS) associated with force/Risk indicator |
| 5a.3 | Carpal tunnel syndrome (CTS) associated with posture/Risk indicator |
| 5a.4 | Carpal tunnel syndrome (CTS) associated with vibration/Risk indicator |
| 5a.5 | Epidemiologic studies evaluating carpal tunnel syndrome (CTS)
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Epidemiologic criteria used to examine studies of carpal tunnel syndrome (CTS) associated with repetition
| Study (first author and year) | Risk indicator (OR, PRR, IR or p-value)*,† | Participation rate >70% | Physical examination | Investigator blinded to case and/or exposure status | Basis for assessing hand exposure to repetition |
| Met all four criteria: | |||||
| Chiang 1990 | 1.87† | Yes | Yes | Yes | Observation or measurements |
| Chiang 1993 | 1.1 | Yes | Yes | Yes | Observation or measurements |
| Moore 1994 | 2.8 | Yes | Yes | Yes | Observation or measurements |
| Osorio 1994 | 6.7 | Yes | Yes | Yes | Observation or measurements |
| Silverstein 1987 | 5.5† | Yes | Yes | Yes | Observation or measurements |
| Met at least one criterion: | |||||
| Barnhart 1991 | 1.9–4.0† | No | Yes | Yes | Observation or measurements |
| Baron 1991 | 3.7 | No | Yes | Yes | Observation or measurements |
| Cannon 1981 | 2.1 | NR‡ | Yes | NR | Job titles or self-reports |
| English 1995 | 0.4 | Yes | Yes | Yes | Job titles or self-reports |
| Feldman 1987 | 2.26† | Yes | No | NR | Observation or measurements |
| McCormack 1990 | 0.5 | Yes | Yes | NR | Job titles or self-reports |
| Morgenstern 1991 | 1.88 | Yes | No | No | Job titles or self-reports |
| Nathan 1988 | 1.0 | NR | Yes | NR | Observation or measurements |
| Nathan 1992a | 1.0 | No | Yes | NR | Observation or measurements |
| Punnett 1985 | 2.7† | No | Yes | NR | Job titles or self-reports |
| Schottland 1991 | 2.86†, 1.87 | NR | Yes | NR | Job titles or self-reports |
| Stetson 1993 | NR | Yes | Yes | NR | Observation or measurements |
| Weislander 1989 | 2.7† | Yes | Yes | No | Job titles or self-reports |
| Met none of the criteria: | |||||
| Liss 1995 | 5.2 3.7† |
No | No | No | Job titles or self-reports |
*Some risk indicators are based on a combination of risk factors—not on repetition alone (i.e., repetition plus force, posture, or vibration). Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).
†Indicates statistical significance.
‡Not reported.
Epidemiologic criteria used to examine studies of carpal tunnel syndrome (CTS) associated with force
| Study (first author and year) | Risk indicator (OR, PRR, IR or p-value)*,† | Participation rate >70% | Physical examination | Investigator blinded to case and/or exposure status | Basis for assessing hand exposure to force |
| Met all four criteria: | |||||
| Chiang 1993 | 1.8† | Yes | Yes | Yes | Observation or measurements |
| Moore 1994 | 2.8 | Yes | Yes | Yes | Observation or measurements |
| Osorio 1994 | 6.7 | Yes | Yes | Yes | Observation or measurements |
| Silverstein 1987 | 15.5† | Yes | Yes | Yes | Observation or measurements |
| Met at least one criterion: | |||||
| Armstrong 1979 | 2.0† | NR‡ | No | No | Observation or measurements |
| Baron 1991 | 3.7 | No | Yes | Yes | Observation or measurements |
| McCormack 1990 | 0.4-0.9 | Yes | Yes | NR | Job titles or self-reports |
| Nathan 1988 | 1.7-2.0† | NR | Yes | NR | Observation or measurements |
| Nathan 1992a | 1.0, 1.4†, 1.6 | No | Yes | NR | Observation or measurements |
| Punnett 1985 | 2.7† | No | Yes | NR | Job titles or self-reports |
| Stetson 1993 | NR† | Yes | Yes | NR | Observation or measurements |
*Some risk indicators are based on a combination of risk factors—not on force alone (i.e., force plus repetition, posture, or vibration). Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).
†Indicates statistical significance. If combined with NR, a significant association was reported without a numerical value.
‡Not reported.
Epidemiologic criteria used to examine studies of carpal tunnel syndrome (CTS) associated with posture
| Study (first author and year) | Risk indicator (OR, PRR, IR or p-value)*,† | Participation rate >70% | Physical examination | Investigator blinded to case and/or exposure status | Basis for assessing hand exposure to posture |
| Met all four criteria: | |||||
| Moore 1994 | 2.8 | Yes | Yes | Yes | Observation or measurements |
| Silverstein 1987 | NR‡ | Yes | Yes | Yes | Observation or measurements |
| Met at least one criterion: | |||||
| Armstrong 1979 | 2.0† | NR | No | No | Observation or measurements |
| deKrom 1990 | 5.4† | Yes | Yes | NR | Job titles or self-reports |
| English 1995 | 1.8† | Yes | Yes | Yes | Job titles or self-reports |
| Stetson 1993 | NR† | Yes | Yes | NR | Observation or measurements |
| Tanaka 1995 | 5.9† | Yes | No | No | Job titles or self-reports |
| Met none of the criteria: | |||||
| Liss 1995 | 3.7† | No | No | No | Job titles or self-reports |
*Some risk indicators are based on a combination of risk factors—not on posture alone (i.e., posture plus repetition, force, or vibration). Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).
†Indicates statistical significance. If combined with NR, a significant association was reported without a numerical value.
‡Not reported.
Epidemiologic criteria used to examine studies of carpal tunnel syndrome (CTS) associated with vibration
| Study (first author and year) | Risk indicator (OR, PRR, IR or p-value)*,† | Participation rate >70% | Physical examination | Investigator blinded to case and/or exposure status | Basis for assessing hand exposure to vibration |
| Met all four criteria: | |||||
| Chatterjee 1992 | 10.9† | Yes | Yes | Yes | Observation or measurements |
| Silverstein 1987 | 5.3† | Yes | Yes | Yes | Observation or measurements |
| Met at least one criterion: | |||||
| Bovenzi 1991 | 21.3† | NR‡ | Yes | Yes | Observation or measurements |
| Bovenzi 1994 | 3.4† | Yes | Yes | No | Observation or measurements |
| Cannon 1981 | 7.0† | NR | Yes | NR | Job titles or self-reports |
| Färkkilä 1988 | NR† | NR | Yes | NR | Job titles or self-reports |
| Koskimies 1990 | NR† | NR | Yes | No | Observation or measurements |
| Tanaka In Press | 1.8† | Yes | No | No | Job titles or self-reports |
| Weislander 1989 | 3.3† | Yes | Yes | No | Job titles or self-reports |
*Some risk indicators are based on a combination of risk factors—not on vibration alone (i.e., vibration plus repetition, posture, or force). Odds ratio (OR), prevalence rate ratio (PRR), or incidence ratio (IR).
†Indicates statistical significance. If combined with NR, a significant association was reported without a numerical value.
‡Not reported.
